Dec 23, 2014

    Keep stress at bay with these tips

    STRESS is part and parcel of life; it affects people across ages, regardless of gender and socio-economic background.

    This is particularly true for people living in a city-state such as Singapore, where people experience higher levels of stress compared to those in the countryside.

    When we are under stress, our bodies activate an automatic response by releasing stress hormones such as adrenalin into our bloodstream.

    These hormones lead to a spike in blood pressure and increase our heartbeat, breathing rate, muscle tension and so on.

    This automatic response is known as the stress response. While we need some stress to boost our motivation, performance and sense of excitement, excessive stress can have an impact on our well-being.

    Research on psychoimmunology shows that the prolonged activation of stress response impairs our immune system and leads to chronic inflammation.

    Inflammation has been linked to a variety of illnesses, from physical ones such as diabetes and heart disease to mental ones like depression and insomnia.

    Thus, stress is a double-edged sword that can lead to both positive and negative consequences. The issue is how to manage stress healthily and effectively.

    With the advancement of Mind Body medicine, pioneered by Herbert Benson at The Benson-Henry Institute for Mind Body Medicine, various evidence-based stress-reduction techniques have been developed to elicit the relaxation response.

    The relaxation response is the opposite of the stress response. Regular practice of these techniques can reverse the toxic effects of chronic stress by slowing breathing rate, relaxing muscles, reducing blood pressure and enhancing the immune system.

    These techniques, coupled with other stress-management strategies, can promote a sense of happiness, satisfaction and calmness as well as long-term health.

    Here are some tips to manage stress in a fast-paced and competitive environment:


    Learn one or two evidence-based stress-reduction techniques that suit you, and practise them on a daily basis to elicit the relaxation response.

    Listen to guided stress-reduction CDs or audio tracks. In caring for our patients in the area of stress reduction, the National Healthcare Group Polyclinics' Psychology Services team has produced a relaxation CD which they can use to reduce stress.

    The audio tracks are also available online (

    Here are two brief and easy-to-do stress-reduction techniques:

    1. Two-step mindfulness practice

    This technique involves two basic steps: repeating a word or muscular activity and breathing, while passively disregarding thoughts that come to the mind, before returning to the first step. To do this, you need to:

    (i) Pick a focus word or short phrase such as "peace", "calm" or "one".

    (ii) Sit quietly and get comfortable.

    (iii) Relax your muscles progressively from your toes to the top of your head.

    (iv) Breathe gently and naturally. Say your focus word silently as you breathe out.

    (v) When your mind has wandered, gently bring your attention back to repeating your focus word and breathing.

    2. Sensory awareness

    Direct your attention to your environment and task at hand in day-to-day activities by using your five senses: sight, sound, touch, smell and taste.

    For example, listen to the sounds created when you are sweeping the floor and look at the movement of the broom.

    Notice the texture and temperature of the floor with your feet.

    Direct your attention back to your focus point when your mind wanders.


    Write down the causes of your stress. Prioritise your commitments and problems.

    Examine whether there are tasks and procedures that can be simplified and eliminate those that are not essential.

    Work on problems that are simple and within your control first, before moving on to more complex ones.

    Be mindful of the way you think and things you do that may exacerbate the stressors.


    Engage in physical activity with moderate intensity to stimulate the production of relaxation hormones, or endorphins.

    Maintain a healthy and balanced diet, and consider dietary supplements such as Omega 3, which has been found to help with depression and inflammation.


    A strong social-support network of family members, friends and colleagues can provide emotional and instrumental support when you are stressed.

    Cultivate these relationships by having meals with them, organising get-togethers during festive seasons, responding to e-mail messages and calls, or starting an interest group.

    You can also expand your social-support network by participating in activities at community centres and faith-based organisations.

    The writer is a psychologist at Collaborative Care, Clinical Services, National Healthcare Group Polyclinics.